Dataset Information

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine.

ABSTRACT:

Background

The association of a higher body mass index (BMI) with better survival is a well-known "obesity paradox" in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of gender on the obesity-mortality relationship in Korean patients on HD.

Methods

This study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970). The relationship between categorized BMI and gender-specific mortality was evaluated by an adjusted Cox proportional hazard model with restricted cubic spline analyses and the Competing risk analysis. We also investigated the effect of changes in BMI over 12 months and serum creatinine level on survival in male and female patients on HD.

Results

The mean BMI was 22.6 ± 3.3 kg/m2 and the mean follow up duration was 24.2 ± 3.4 months. The patients with the highest quintile of BMI (≥25.1 kg/m2) showed lower mortality (subdistributional hazard ratio [SHR] = 0.63, 95% confidence interval [CI] = 0.43-0.93, P = 0.019) compared with those with the reference BMI quintile. When analyzed by gender, male patients with a BMI over 25.1 kg/m2 had lower mortality risk (HR = 0.43, 95% CI = 0.25-0.75, P = 0.003); however, no significant difference was found in female patients. Increased BMI after 12 months and high serum creatinine were associated with better survival only in male patients on HD.

Conclusions

BMI could be used as a risk factor for mortality in male patients on HD. However, the mortality of female patients on HD was not related with baseline and follow-up BMI. This suggests that BMI is a good surrogate marker of lean body composition, especially in male patients on HD.

SUBMITTER: Park JM

PROVIDER: S-EPMC5955527 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine.

Park Jeung-Min JM Lee Jong-Hak JH Jang Hye Min HM Park Yeongwoo Y Kim Yon Su YS Kang Shin-Wook SW Yang Chul Woo CW Kim Nam-Ho NH Kwon Eugene E Kim Hyun-Ji HJ Lee Ji-Eun JE Jung Hee-Yeon HY Choi Ji-Young JY Park Sun-Hee SH Kim Chan-Duck CD Cho Jang-Hee JH Kim Yong-Lim YL

PloS one 20180516 5

<h4>Background</h4>The association of a higher body mass index (BMI) with better survival is a well-known "obesity paradox" in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of gender on the obesity-mortality relationship in Korean patients on HD.<h4>Methods</h4>This study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970 ...[more]

PMID: 29768438

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Dataset Information

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine.

Background

Methods

Results

Conclusions

Publications

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine.

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